Role of compression stockings after endovenous laser therapy for primary varicosis

Jan H Elderman; Attila G Krasznai; Adri C Voogd; Karel W E Hulsewé; Cornelis J J M Sikkink

doi:10.1016/j.jvsv.2014.01.003

Role of compression stockings after endovenous laser therapy for primary varicosis

J Vasc Surg Venous Lymphat Disord. 2014 Jul;2(3):289-96. doi: 10.1016/j.jvsv.2014.01.003. Epub 2014 Feb 14.

Authors

Jan H Elderman¹, Attila G Krasznai², Adri C Voogd³, Karel W E Hulsewé², Cornelis J J M Sikkink⁴

Affiliations

¹ Department of Surgery, Atrium Medical Center and Orbis Medical Center, Sittard, The Netherlands; Department of Internal Medicine, Ikazia Hospital, Rotterdam, The Netherlands.
² Department of Surgery, Atrium Medical Center and Orbis Medical Center, Sittard, The Netherlands.
³ Department of Epidemiology, Maastricht University Medical Center, Maastricht, The Netherlands.
⁴ Department of Surgery, Atrium Medical Center and Orbis Medical Center, Sittard, The Netherlands. Electronic address: k.sikkink@orbisconcern.nl.

PMID: 26993388
DOI: 10.1016/j.jvsv.2014.01.003

Abstract

Objective: The objective of this prospective, randomized trial was to evaluate the effect of compression stockings after endovenous laser therapy (EVLT) for insufficiency of the great saphenous vein. Effect evaluation was focused on differences in postoperative pain within 6 weeks.

Methods: The study randomized 111 patients undergoing EVLT for duplex ultrasound-confirmed great saphenous vein insufficiency (C2-4EPASPR) to receive either 2 weeks of elastic stockings (class II, thigh length) or no elastic stockings after an initial 24-hour period of wearing bandages. Patients registered pain scores (primary outcome) and use of analgesics in a diary on a visual analog scale. At 2 days, 14 days, and 6 weeks after the procedure, leg circumferences, Aberdeen Varicose Vein Questionnaire scores, RAND 36-Item Health Survey scores, patient satisfaction (5-point scale), time before returning to work, and adverse events (secondary outcomes) were evaluated.

Results: In the 79 patients (15 men and 64 women; mean age, 52 years) who completed the treatment and follow-up, small but significant differences in pain scores were observed during the first week after laser surgery, with more favorable scores in the group wearing stockings. Patients not wearing stockings used more analgesics than did patients wearing stockings (P < .05). Patients wearing stockings reported a statistically significantly higher score of satisfaction at 2 days (4.44 vs 4.15) and 6 weeks (4.59 vs 4.18), although the absolute differences were small. No significant differences were found regarding time to return to work, Aberdeen Varicose Vein Questionnaire scores, RAND 36-Item Health Survey scores, leg circumference measurements, and risk of complications.

Conclusions: Wearing of postoperative stockings for 2 weeks after an initial 24-hour period of wearing bandages results in a small but significant reduction of postoperative pain and use of analgesics compared with not wearing compression stockings after EVLT for great saphenous vein insufficiency.